Therapy Medicaid rates in Kentucky divide sharply between speech and everything else. Kentucky Medicaid pays $70.16 an hour for physical therapy under code 97110, which ranks 45th of 49 states and is 26.9% below the national median of $96.04. The rate is $17.54 per 15-minute unit, effective 2026-01-01.
Speech therapy is priced on a different scale. Code 92507 pays $34.38 per 15 minutes, or $137.52 an hour, far above the PT hour. At Kentucky wages, that turns speech into the one therapy line with a wide margin, while physical therapy barely covers a therapist's pay. All rates are compiled from official Kentucky Department for Medicaid Services (DMS) publications, and the Kentucky Medicaid rates hub links each to its source document.
- Physical therapy, 97110: $17.54 per 15 minutes ($70.16 an hour), 45th of 49 states, 26.9% below the median.
- Occupational therapy, 97533: $20.94 per 15 minutes ($83.76 an hour), 38th of 48 states, 24.3% below the median.
- Speech therapy, 92507: $34.38 per 15 minutes ($137.52 an hour), effective 2025-01-01.
- PT evaluation, 97163: $34.88 per visit.
- OT evaluation, 97167: $35.66 per visit.
- Speech-language evaluation, 92522: $67.98 per visit.
Apart from speech treatment, every rate carries the 2026-01-01 effective date. The speech evaluation also pays far more than the PT and OT evaluations, so the speech advantage runs through the whole episode.
DMS publishes fee schedules by service type, including a dedicated physical therapy fee schedule for 2026 alongside the physician, home health and other schedules. The rates on this page come from those DMS publications, and each has its own effective date.
Units, visits and hourly comparisons
Kentucky prices the treatment codes on this page in 15-minute units, including speech therapy under 92507, which many states price per session. Four units make the hourly figures used for comparison. The evaluations are priced per visit. Because speech is unit-priced in Kentucky, a longer speech session earns more, which is not the case in states that pay a flat amount per session.
Different schedules, different prices
The same code can appear on more than one Kentucky schedule with a different price, depending on the provider type billing it. A therapy practice should confirm which DMS schedule applies to its enrollment before building billing templates, and should not assume the rate a hospital or physician group receives for a therapy code is the rate a therapy practice receives.
Kentucky pays $17.54 per unit of 97110, or $70.16 an hour, effective 2026-01-01. Only a handful of states pay less, including New Jersey ($58.80), California ($48.88) and Maine ($46.64). Occupational therapy under 97533 is better, at $83.76 an hour, but still 24.3% below the national OT median and 38th of 48 states.
For a PT practice, the 2026 effective date offers no relief: the rate is current, not stale, which means it reflects a recent pricing decision rather than years of neglect. Practices should not plan on a catch-up increase.
Kentucky wages are below the national medians for every therapy role. In May 2025, physical therapists earned a median $48.42 an hour against $49.40 nationally, occupational therapists $46.95 against $48.24, and speech-language pathologists $40.17 against $47.05. Physical therapist assistants earned $29.56 against $32.88, and occupational therapy assistants $31.36 against $34.76.
The economics of each discipline diverge:
| Service | Rate per hour | Median wage | Wage share | Margin per hour |
|---|---|---|---|---|
| Physical therapy | $70.16 | $48.42 | 98.1% | $1.34 |
| Occupational therapy | $83.76 | $46.95 | 79.7% | $17.03 |
| Speech-language therapy | $137.52 | $40.17 | 41.5% | $80.43 |
A physical therapy hour in Kentucky leaves $1.34 after a loaded wage, effectively nothing for overhead. A speech hour leaves $80.43. For a multi-discipline pediatric practice, that gap decides staffing: speech-language pathologists generate most of the Medicaid margin, and physical therapy is close to break-even before any overhead is counted.
PT practices serving Kentucky Medicaid patients will generally need physical therapist assistants, high scheduling density or a larger commercial share to cover costs. The PTA wage of $29.56, below the national $32.88, gives some relief where Kentucky rules allow assistant-delivered treatment.
The low evaluation rates compound the problem. A PT evaluation under 97163 pays $34.88 per visit and an OT evaluation under 97167 pays $35.66, both well under the national medians of $81.72 and $82.41. A PT episode in Kentucky therefore starts with a modest intake payment and continues at one of the lowest hourly treatment rates in the country, which leaves little room for unbilled time at either end of the plan of care.
Kentucky is one of the clearest cases in the country of a single discipline carrying the Medicaid book.
Staffing mix
A practice that adds a speech-language pathologist adds the highest-margin Medicaid hour in the state. A practice that adds a physical therapist for Medicaid volume adds an hour that barely covers its own wage. Multi-discipline clinics should plan growth with that asymmetry in mind.
Episode structure
The speech-language evaluation pays $67.98, about double the PT and OT evaluations, and the unit-priced speech treatment rewards full-length sessions. Speech episodes are therefore well paid at both ends, which makes speech intake worth investing in.
Cross-subsidy risk
Clinics that use speech margin to support PT should track each line separately. If speech rates change, a cross-subsidized PT program can turn from break-even to loss-making quickly.
Kentucky attaches authorization rules to every listed therapy code:
- 92507 and 97530: four prior-authorization rules each.
- 97110 (therapeutic exercise): three rules.
- 92521 to 92524, 97112 and the evaluation codes 97161 to 97168: one rule each.
No unit limits are listed. Because speech is the most valuable service line in Kentucky and also carries the most authorization rules, a lapsed approval on 92507 is the costliest administrative error a Kentucky therapy practice can make. Intake workflows should confirm speech authorizations before the first treatment visit and track renewal dates closely.
For physical, occupational and speech therapy in Kentucky, the rule on file is: plans negotiate; the published rate applies out of network. The same rule applies to physician services, hospital outpatient care and home health. Our data counts 15 plans and programs, including PACE organizations such as Bluegrass Care Navigators and Senior CommUnity Care of Kentucky. Kentucky also runs managed-care state directed payments (HRIP, URIP, KTHRI, APAP, ASPP and pharmacy programs).
For therapy practices, the plan contract is the rate that matters in network. The published DMS schedule is a useful benchmark when negotiating, particularly for PT, where the fee-for-service rate leaves almost no margin: a plan offer at or below the DMS PT rate is an offer to work at break-even. The Kentucky managed-care page lists the plans on file.
Preparing for a plan negotiation
Because Kentucky plans are free to set their own therapy rates, the strongest case a practice can bring is its own data. Useful evidence includes visit counts and outcomes by discipline, cancellation and no-show rates, the share of the plan's members the practice serves in its area, and the cost of the authorization work each episode requires. For physical therapy, the argument is straightforward: at the DMS rate and a median wage, a PT hour leaves $1.34, so a plan that wants reliable PT access for its members has a reason to pay above the schedule. For speech, where the DMS rate is already strong, the goal is usually to protect that rate rather than to raise it, and to make sure contract language ties the plan's speech rate to the published unit rate rather than to a flat per-session amount.
In mid-2026, DMS issued a provider letter on the Medicaid budget's impact on provider reimbursement, followed by an update to that letter. Therapy practices should read both, together with the next edition of the DMS physical therapy fee schedule, to confirm whether any change reaches therapy codes. With PT margins near zero, even a small reduction would push physical therapy below break-even at median wages.
On physical therapy, Kentucky's $70.16 sits far below Alaska ($176.68), New Mexico ($165.64), Montana ($147.04) and Texas ($135.00). On occupational therapy, the leaders are Alaska ($338.72), New Mexico ($198.64) and Montana ($197.20), while Kentucky's $83.76 sits well down the table. Neighboring Tennessee therapy rates offer a regional comparison.
- Budgeting: model each discipline separately; a blended rate hides a near-zero PT margin.
- Contracting: push for plan rates above the DMS schedule for PT; accept the schedule as a floor reference for speech.
- Authorization: prioritize speech and 97530 approvals, which carry the most rules.
- Monitoring: follow DMS provider letters and new fee schedule editions.
Rates on this page are compiled from official DMS publications, including the KY Medicaid PT fee schedule for 2026. Each rate links to its source document. Hourly figures convert 15-minute units to an hour; ranks compare the same service across states. Wages are May 2025 medians.
This page covers therapy only; the Kentucky Medicaid rates hub covers all 39,971 current Kentucky Medicaid rates. See the national therapy rates hub, our methodology and pricing.